Adherence to oral antineoplastic agents by cancer patients: definition and literature review.

Since the 1990s, oral chemotherapy has been gaining ground as cancer treatment. This therapy seems to have few toxic effects and offers patients good quality of life. However, in addition to the fears the therapy might generate in patients, oral treatment raises a new issue, which, until now, has been marginal in this field: therapeutic observance or adherence. We investigated the research into adherence to oral chemotherapy among cancer patients published between 1990 and July 2013. Studies showed considerable diversity in terms of both the definition and measurement of adherence. As well, adherence to antineoplastic therapy is affected by the patient's understanding of the treatment and ability to remember information provided by the physician, treatment length and psychological distress. Our review of the few studies on adherence to anticancer drug treatment raises some questions that could be pursued in future research. In light of our findings, patients should receive 'therapy education' to help them and their support groups better understand the disease and its treatment and to achieve optimal health management and improved treatment effectiveness.

[Multidimensional homogeneity analysis with small samples: comparison of different subgroups of people suffering from exclusion]. / Analyse multidimensionnelle d'homogénéité sur échantillons restreints: comparaison entre différents sous-groupes d'individus en situation d'exclusion.

With the aim of studying the relationship between harmful biographical events and exclusion we have developed a rating scale for semi-structured biographical interviews. The rating scale was constructed in accordance with the phenomenological and structural approach and allows us gathering some clinically pertinent indicators concerning the course of life, the nature of the trauma, the composition of the original family, the life period of emotional pain and the current familiar and social support. The homogeneity or multiple correspondence analysis (HOMALS) led to the extraction of the fundamental dimensions underlying the data of three clinical subgroups of people suffering from exclusion and marginalization: homeless and long term unemployed people, immigrants, political refugees and asylum seekers, drug addicts. The results demonstrate the relevance of the multidimensional homogeneity analysis applied to this kind of data. On one hand they suggest a theoretical model of the relationship between harmful biographical events, vulnerability, exclusion and psychopathological complications. On the other hand they show that we are facing differential psychological profiles which will be studied thoroughly during the next stages of our research.